| NPI | 1962993915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12039) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: TX PA12039) |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2025-04-03 |