| NPI | 1609427194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA14903) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 58989) |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2021-10-20 |