| NPI | 1962442327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: TX PA04644) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2020-02-05 |