| NPI | 1558646711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07588) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2022-03-26 |