| NPI | 1962488452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09512) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 2554) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2015-05-21 |