| NPI | 1740680271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12452) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05786) |
| Enumeration Date | 2014-09-03 |
| Last Update Date | 2019-02-08 |