| NPI | 1568504827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07388) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DC 247) |
| 363AM0700X Physician Assistant, Medical (Licence: LA PA.200446) | |
| 363AM0700X Physician Assistant, Medical (Licence: DC PA247) | |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA07388) | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2021-04-14 |