| NPI | 1720379126 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07312) | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| Enumeration Date | 2011-04-20 | 
| Last Update Date | 2012-05-14 |