| NPI | 1679712244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA06058) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA151212) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX pending) | |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2013-05-09 |