| NPI | 1669825782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13990) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2585) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2021-01-29 |