| NPI | 1851974836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16879) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110007723) |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2025-02-10 |