| NPI | 1568404002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18149) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA00029) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2024-11-15 |