| NPI | 1568831022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16825) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2024-09-19 |