| NPI | 1639617376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11214) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: TX MED-PAC-LIC-76233) | |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2019-08-01 |