| NPI | 1710457023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA12210) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX PA12210) |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2020-06-09 |