| NPI | 1760135842 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX 90418-283224121911) | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical | 
| 374U00000X Home Health Aide | |
| Enumeration Date | 2022-01-30 | 
| Last Update Date | 2022-01-30 |