| NPI | 1396991543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05927) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX 1082639) |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2023-09-24 |