| NPI | 1750850996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX 18470) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-11-16 |
| Last Update Date | 2024-12-10 |