| NPI | 1083942817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA06372) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA06372) |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2016-08-30 |