| NPI | 1497073514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA06752) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 5047) |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2021-09-23 |