| NPI | 1730119108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA02113) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: LA PA.200176) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2008-08-13 |