| NPI | 1659325272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09342) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA00816) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2015-08-12 |