| NPI | 1467789628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15781) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 47313) |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2022-06-16 |