| NPI | 1508177122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA06768) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2012-08-28 |