| NPI | 1407331747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12320) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2021-08-30 |