| NPI | 1962773762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07572) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: TX PA07572) |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2023-08-16 |