| NPI | 1316362353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 4833428-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 4833428-8906) |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2014-02-27 |