| NPI | 1548355548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07983) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA PA.200174.RX) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2016-02-06 |