| NPI | 1700950334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14124) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 200112) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2021-07-08 |