| NPI | 1528423043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11730) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019416) |
| Enumeration Date | 2015-12-28 |
| Last Update Date | 2023-04-21 |