| NPI | 1255546453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA04709) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA19167) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2011-05-31 |