| NPI | 1679964886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09665) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2020-02-05 |