| NPI | 1720535750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX 12495) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 6450) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2019-01-14 |