| NPI | 1265777544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9106163) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX 00269) |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2013-06-10 |