| NPI | 1518975127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 7046321-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 7046321-8906) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2021-11-10 |