| NPI | 1982643292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA04612) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA66038) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2025-03-14 |