| NPI | 1609411222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX PA13170) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA13170) |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2022-04-11 |