| NPI | 1891558078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17602) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX PA17602) |
| Enumeration Date | 2024-01-31 |
| Last Update Date | 2024-04-09 |