| NPI | 1811227648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08650) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013779) |
| Enumeration Date | 2009-12-29 |
| Last Update Date | 2014-11-07 |