| NPI | 1033620323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11485) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX PA11485) |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2019-04-22 |