| NPI | 1992315899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15111) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: TX PA15111) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2024-03-02 |