| NPI | 1891165338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12156) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108979) |
| Enumeration Date | 2015-09-27 |
| Last Update Date | 2024-05-18 |