| NPI | 1013313063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15743) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OK 2027) |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2022-11-14 |