| NPI | 1871515080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA04546) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA04546) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2025-08-08 |