| NPI | 1952071680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14978) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX PA14978) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2022-01-13 |