| NPI | 1508334095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12229) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 092532) |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2023-01-30 |