| NPI | 1548292774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA02055) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX 1036559) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2008-07-30 |