| NPI | 1508911314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114320) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA02114) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2021-06-04 |