| NPI | 1831433861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA08075) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX PA08075) |
| 363A00000X Physician Assistant (Licence: MA PA5504) | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2022-10-09 |