| NPI | 1174860696 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09152)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 88249)  | 
| Enumeration Date | 2013-01-04 | 
| Last Update Date | 2024-03-04 |