| NPI | 1538423850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA 09188) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 2150) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2017-01-09 |