| NPI | 1609923341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA06756) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MT 325) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-09-30 |