| NPI | 1861614109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA01815) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA 01815) |
| 208000000X Pediatrics (Licence: TX PA01815) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2014-06-25 |