| NPI | 1699011098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08199) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX 1108732) |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2022-11-28 |