| NPI | 1497113260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10413) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 2641) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2021-08-25 |