| NPI | 1912288069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09570) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106124) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2023-06-19 |