| NPI | 1750643821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07663) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: TX PA07663) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2022-10-26 |