| NPI | 1629027461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA02712) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: TX PA02712) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2018-06-06 |