| NPI | 1164032280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15014) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX PA15014) |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2023-05-02 |