| NPI | 1992992952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 6731065-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0756) |
| 363A00000X Physician Assistant (Licence: MP 0069) | |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2022-04-07 |