| NPI | 1912915927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00367) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA07226) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2022-06-13 |