| NPI | 1730873217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA17720) |
| Enumeration Date | 2023-06-07 |
| Last Update Date | 2024-03-10 |