| NPI | 1689185076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12410) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059360) |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2022-03-28 |