| NPI | 1710123336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14057) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04961) |
| Enumeration Date | 2009-01-02 |
| Last Update Date | 2024-10-13 |