| NPI | 1518385608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08939) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9113892) |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2023-05-03 |