| NPI | 1265439558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA03038) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 010123) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2022-12-23 |