| NPI | 1487823704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07283) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2008002536) |
| 363A00000X Physician Assistant (Licence: IA 002096) | |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2011-09-21 |