| NPI | 1598031841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA08606L) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC004286L) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA003432L) | |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2023-01-08 |