| NPI | 1235594425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11893) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA11893) |
| Enumeration Date | 2015-12-15 |
| Last Update Date | 2022-03-18 |