| NPI | 1023674298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15829) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA57394) |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2024-09-19 |