| NPI | 1730192428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA04492) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA919) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2018-03-17 |