| NPI | 1477178796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14866) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9113334) |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2021-09-03 |