| NPI | 1316746175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA19058) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2025-03-12 |
| Last Update Date | 2025-07-29 |