| NPI | 1477325025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18273) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9117776) |
| Enumeration Date | 2023-10-26 |
| Last Update Date | 2025-09-22 |