| NPI | 1912928359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05492) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 004523) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2016-11-11 |