| NPI | 1396722997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09762) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9102985) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2024-09-12 |