| NPI | 1336481274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 6358658-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA22848) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2013-03-19 |