| NPI | 1598026254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NC 0010-08470) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: TX PA07792) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2019-02-20 |