| NPI | 1831556158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10776) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9108532) |
| Enumeration Date | 2016-01-16 |
| Last Update Date | 2021-02-19 |