| NPI | 1790728368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11298) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9118032) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2024-04-12 |