| NPI | 1891981023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001002899) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA05306) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2019-02-20 |