| NPI | 1770966384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12941) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA PA.200836) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2023-01-10 |