| NPI | 1669915716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10924) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110005591) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2023-04-04 |