| NPI | 1508250606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12115) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9108594) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2021-10-12 |