| NPI | 1841613817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08959) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX TL) |
| Enumeration Date | 2014-01-28 |
| Last Update Date | 2020-09-17 |