| NPI | 1629095559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12152) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: DE C5-0000337) |
| 363A00000X Physician Assistant (Licence: PA MA052372) | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2025-01-31 |