| NPI | 1891744132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05450) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 3346) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2018-04-30 |