| NPI | 1831447531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA10245) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4455) |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2015-12-13 |