| NPI | 1477535052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA01264) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54327) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2018-12-19 |