| NPI | 1811272404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07943) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5031) |
| Enumeration Date | 2011-10-15 |
| Last Update Date | 2012-12-29 |