| NPI | 1144826041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9120807) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA14209) |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2026-01-12 |