| NPI | 1801307707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12477) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD c0006595) |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2019-10-28 |