| NPI | 1649571738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08695) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 200399) |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2014-08-19 |