| NPI | 1770372096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA19170) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2025-05-02 |
| Last Update Date | 2025-06-12 |