| NPI | 1659464246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08427) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 00533) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2023-03-21 |