| NPI | 1558078360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18143) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-11-01 |
| Last Update Date | 2025-02-20 |