| NPI | 1093429193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16846) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA66263) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2023-01-12 |
| Last Update Date | 2025-04-04 |