| NPI | 1730545898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16092) |
| Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: TX DT83853) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA16092) | |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2023-07-03 |