| NPI | 1013998566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA05356) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2018-04-12 |