| NPI | 1578088811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11414) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA11414) | |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2024-05-08 |