| NPI | 1932246147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA04260) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: TX PA04260) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2024-02-26 |