| NPI | 1932578515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10600) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108958) |
| Enumeration Date | 2015-09-24 |
| Last Update Date | 2022-07-21 |