| NPI | 1487084646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110388) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: TX PA08668) | |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2021-03-10 |