| NPI | 1255531943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08935) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053057) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2015-06-03 |