| NPI | 1689078370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09336) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2025025710) |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2025-06-30 |