| NPI | 1952992901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14208) |
| Additional Taxonomies | 282NC2000X General Acute Care Hospital, Children (Licence: TX PA14208) |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2022-07-20 |