| NPI | 1851558639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05855) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR PA00854) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2012-03-28 |