| NPI | 1619228798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11049) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0003574) |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2022-10-19 |