| NPI | 1972093821 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant | 
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT84002)  | 
| Enumeration Date | 2018-05-16 | 
| Last Update Date | 2024-09-16 |