| NPI | 1437460300 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA06750) | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX Applicant) | 
| Enumeration Date | 2010-06-25 | 
| Last Update Date | 2011-10-24 |