| NPI | 1477828291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA9106396) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL Pa9106396) |
| Enumeration Date | 2012-03-12 |
| Last Update Date | 2019-08-26 |