| NPI | 1649542291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA11939) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 3383) |
| 363AM0700X Physician Assistant, Medical (Licence: NE 1655) | |
| Enumeration Date | 2012-01-29 |
| Last Update Date | 2018-07-27 |