| NPI | 1477035103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5621) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX 682032) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2023-12-06 |