| NPI | 1073988895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10345) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: TX PA10345) |
| Enumeration Date | 2015-12-04 |
| Last Update Date | 2020-10-27 |