| NPI | 1861767774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14497) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT81600) |
| Enumeration Date | 2012-03-12 |
| Last Update Date | 2022-01-10 |