| NPI | 1265717375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09853) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00268700) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2023-04-07 |