| NPI | 1790243400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12647) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1826) |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2022-11-10 |