| NPI | 1225790280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16969) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 329004) |
| Enumeration Date | 2021-10-07 |
| Last Update Date | 2024-07-05 |