| NPI | 1427688365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110010088) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA13872) |
| Enumeration Date | 2020-01-20 |
| Last Update Date | 2025-03-04 |