| NPI | 1457770315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13582) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 2608) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2020-03-30 |