| NPI | 1225635311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14003) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 714785) |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2025-09-02 |