| NPI | 1821386996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07372) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX Temp License) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2021-07-01 |