| NPI | 1821031279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA01978) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA02966) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2019-11-01 |