| NPI | 1659848356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA12333) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX TEMP) |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2019-04-10 |