| NPI | 1538339684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114376) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX pa05691) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2022-03-22 |