| NPI | 1750766432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09907) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2696) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2015-07-23 |