| NPI | 1790130433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10599) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PAT) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2017-03-16 |