| NPI | 1952655185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09929) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA60318338) |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2023-11-29 |