| NPI | 1548431901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10002) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2581) |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2016-01-13 |