| NPI | 1184447310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX S9Y8B7Y5) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: TX NA0008881070) |
| Enumeration Date | 2024-11-06 |
| Last Update Date | 2024-11-06 |