| NPI | 1720459043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11500) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: AZ 6227) |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2022-12-16 |