| NPI | 1922035179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA 03470) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA03470) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA03470) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2020-02-18 |