| NPI | 1932664570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15379) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1282170) |
| Enumeration Date | 2019-02-07 |
| Last Update Date | 2022-03-25 |