| NPI | 1205131323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09756) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT81849) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2019-10-22 |