| NPI | 1558157347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18728) |
| Additional Taxonomies | 208VP0000X (Licence: TX PA18728) |
| Enumeration Date | 2025-04-17 |
| Last Update Date | 2025-07-28 |