| NPI | 1023614211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14783) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 4437) |
| Enumeration Date | 2020-12-11 |
| Last Update Date | 2024-09-23 |