| NPI | 1841712064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11315) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX PA11315) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2022-04-01 |