| NPI | 1053714063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA16788) |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2024-08-23 |