| NPI | 1770544199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA03099) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 1790) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2011-08-05 |