| NPI | 1649287814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA04377) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NV PA1032) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2013-09-10 |