| NPI | 1538473343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05721) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX 282N0000X) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2017-01-06 |