| NPI | 1043526833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: TX PA04275) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04275) |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2023-01-19 |