| NPI | 1104572478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15445) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX PA15445) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-02-25 |
| Last Update Date | 2022-04-11 |