| NPI | 1083975726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9106217) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 327164-1206) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PS04308) | |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2012-05-30 |