| NPI | 1528663242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14397) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX PA14397) |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2025-10-23 |