| NPI | 1831406883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C06453) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2158) |
| 363A00000X Physician Assistant (Licence: TX PA07073) | |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2019-06-24 |