| NPI | 1760852800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA14223) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9109107) |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2022-02-09 |