| NPI | 1720043128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA06755) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| 363AS0400X Physician Assistant Surgical (Licence: TX PA06755) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2023-01-26 |