| NPI | 1588134530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12528) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX PA12528) |
| Enumeration Date | 2018-12-03 |
| Last Update Date | 2024-05-01 |