| NPI | 1407044852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05357) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012132) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2017-05-25 |