| NPI | 1508261322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09302) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 200758) |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2016-11-17 |