| NPI | 1518201284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 52054) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA14935) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2023-08-17 |