| NPI | 1225524788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13668) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9111358) |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2020-09-08 |