| NPI | 1558496067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX 06TX1185) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: TX 279307) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2019-04-16 |