| NPI | 1508102542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08108) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3893-023) |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2024-05-24 |