| NPI | 1780023739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16399) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106796) |
| 363A00000X Physician Assistant (Licence: CO PA.0003714) | |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2026-05-27 |