| NPI | 1669803797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08722) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0006512) |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2023-01-31 |