| NPI | 1275386245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA17488) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9118370) |
| Enumeration Date | 2024-04-09 |
| Last Update Date | 2025-05-11 |