| NPI | 1548566714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09356) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-02624) |
| Enumeration Date | 2011-02-04 |
| Last Update Date | 2018-08-15 |