| NPI | 1629606736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15281) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: TX PA15281) |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2022-08-23 |