| NPI | 1386290039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15449) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 7640) |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2026-03-31 |