| NPI | 1154184943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: TX PA17611) |
| 363AM0700X Physician Assistant Medical (Licence: TX 17611) | |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-03-29 |