| NPI | 1316071335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA03515) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA036) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2007-07-09 |