| NPI | 1043865868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA13021) |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2025-02-20 |