| NPI | 1205500907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15868) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI Pending) |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2024-11-12 |