| NPI | 1467030486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA14360) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA14360) |
| 363A00000X Physician Assistant (Licence: AZ 8476) | |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2024-08-26 |