| NPI | 1881904647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07959) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 4702) |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2014-07-14 |