| NPI | 1588107791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12088) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 6586) |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2020-10-02 |