| NPI | 1336974716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18717) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0009826) |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2026-08-18 |