| NPI | 1629318217 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA08311)  | 
| Enumeration Date | 2013-02-19 | 
| Last Update Date | 2024-10-16 |