| NPI | 1992107676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09443) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2018-12-06 |