Mon-Fri: 7:30AM-4:00pm


Dr. Rashmee Patil

Rashmee Patil, MD

CEO and Principal Investigator

Practicing Since: 2012
Specialty: Hepatology, Internal Medicine 
Education: Saint George’s University School of Medicine 
Residency: Internal Medicine at New York University 
Fellowship: Hepatology and Liver Transplantation at Baylor College of Medicine 
Certifications/publications: 15 original publications in peer-reviewed journals, member of the American Board of Internal Medicine, AASLD, EASL 
Provider Background: Dr. Patil brings with her over 11 years of medical experience. Throughout her physician years, Dr. Patil has served as: 
  • Principal Investigator for over 100 research studies in the areas of non-alcoholic fatty liver disease
  • Founder of South Texas Research Institute, the premier clinical research site network of the Rio Grande Valley
  • Director of the Hepatology Department at DHR Liver & Transplant Institute
With her visionary leadership, profound expertise, and unwavering dedication to patient-centered care, Dr. Rashmee Patil joins Pinnacle in revolutionizing the healthcare landscape and making a lasting impact on the lives of individuals and communities.

Madhavi Rudraraju, MD

Principal Investigator
San Antonio, TX

Specialties: Gastroenterology and Transplant Hepatology
Education: Andhra Medical College, 2001
Residency: University of Oklahoma Health Sciences Center, 2006
Transplant Hepatology at Mayo Clinic – Arizona, 2007
Gastroenterology and Hepatology at University of Oklahoma Health Science Center, 2010

Practicing Since: 2010
Certifications/Publications: Over 6 original publications in peer-reviewed journals and 4 publications worldwide. 3 board certifications, and over 2 years of research support in the areas of Non-Alcoholic Fatty Liver Disease.

Provider Background: Dr. Rudraraju is a board certified hepatologist with over 12 years of practice. Throughout her career she has had tremendous positions, including:

Medical Director of Methodist Liver Disease and Transplant Program VNOS Director
Medical Executive Committee as Chief of Transplant service line
Clinical Review Committee
Physician Advisory Committee
Active member of American Medical Association, American College of Gastroenterology, American Gastroenterology Association, and the American Association for the Study of Liver Disease, and European Association for the Study of the Liver (EASL).

Dr. Rudraraju has been with Pinnacle since 2020 and has formed a multitude of relationships with San Antonio’s physicians and experts to raise awareness of liver disease and find a treatment for the patients that need it most.

Carlos Duncker, MD, Phd

Carlos Duncker, MD, PhD

Director of Strategic Partnerships

Education: MD at Autonomous University of Cd. Juarez (Mexico) and PhD at Autonomous University of Barcelona (Spain)
 Residency:Autonomous University of Barcelona
 Research Fellow: Johns Hopkins Medical Institutions
Certifications/publications: Has authored over 170 medical publications and over 20 years of clinical research support in multiple therapeutic areas. He is a founding member of the American Society of Nuclear Cardiology and was a Reviewer for the European Journal of Nuclear Medicine and Molecular Imaging for 12 years, as well as Professor of Medicine and Radiology for over 10 years
Provider Background: Dr. Duncker brings with him over 30 years of healthcare experience. Throughout his years, Dr. Duncker has served as:

  • Global Director of Medical Affairs at Perspectum Ltd.
  • Manager of Hepatology Research at the Texas Digestive Disease Consultants
  • Senior Researcher at National Institutes of Health Research System
  • Head Molecular Nuclear Medicine for the Children’s Hospital of Mexico
With his vast experience in clinical research, site operations, and physician relations, Dr. Duncker joins Pinnacle to help grow by working strategically in existing and new markets to develop and enhance existing partnerships.
Heather Delaney, MD

Heather Delaney, MD

Principal Investigator

Specialty: Pediatrics, Neonatology, Research
Provider Background: Dr. Heather Delaney is a double Board-Certified Pediatrician and Neonatologist with over 20 years of broad experiences in the medical field. She is a 17-year Veteran of the US Air Force and Army. Her areas of expertise include healthcare quality and education, infectious disease monitoring and prevention, medication management and healthcare leadership. She is a Certified Simulation Healthcare Educator and an active contributor to online education platforms for medical students and residents. She has her Black Belt in Lean Six Sigma methodology and is fiercely committed to Zero Harm in healthcare. She has over 15 years of experience in Clinical Research and has over 75 publications, platform and poster presentations within her areas of expertise. She is married to an Active Duty service member of the US Army and has two girls both of whom were born in Hawaii. 

Dimple Patel Desai, MD

Principal Investigator
Brownsville, TX

Specialty: Board Certified in Family Medicine
Medical Education: University of Texas Medical Branch School of Medicine
Residency: University of Texas Medical Branch Hospitals, 2014
Chief Residency: University of Texas Medical Branch Hospitals, 2017
Practicing Since: 2017
Certifications/publications: Dr. Desai is board certified in family medicine and board eligible in Obesity Medicine. She has also done a fellowship in Primary Care Psychiatry (PCP) with UC Irvine/UC Davis. Dr. Desai has published in Integrative Geriatric Medicine by Oxford University Press highlighting integrative remedies for a healthier gut in older adults.
Provider Background: As a native of the Rio Grande Valley in Texas Dr. Desai moved back home in 2017, to care for patients in her home community.
  • Expertise in obesity medicine, integrative medicine, and behavioral health
  • Award-winning author of “The Lambda Factor”
Dr. Desai’s interest in obesity and NAFLD/NASH research brings a dedication to the Pinnacle mission of connecting with like-minded physicians within the Rio Grande Valley.
Hobbies: In her free time, Dr. Desai enjoys traveling around the work to new destinations, reading, writing a sequel to her awarding winning novel, and spending time with her three young boys and family. 
David Ramirez Principal Investigator

David Ramirez Jr., DO

Principal Investigator
Edinburg, TX

Specialty: Board Certified in Family Medicine
Medical Education: University North Texas Health Science Center Texas College of Osteopathic Medicine
Residency: University Texas Rio Grande Valley at DHR
Practicing Since: 2017
Certifications/publications: Board Certified in Family Medicine by the ABFM
Provider Background:  Dr. Ramirez is native to South Texas and has been blessed to have done his undergraduate and graduate school studies in the Rio Grande Valley (UT-PA), medical school in Fort Worth, and then eventually returning for residency training in Edinburg, Tx. He is passionate about disease prevention, chronic disease management, as well as wound and obesity medicine.
Dr. Ramirez has an interest in the areas of NAFLD and NASH research. He joins Pinnacle on their mission and dedication to connect with like-minded local and global physicians on the importance of taking early measures for patients who have been diagnosed with non-alcoholic fatty liver or NASH. 
Hobbies: On his spare time Dr. Ramirez loves playing guitar and piano, learning about data science and programming, and spending time with my wife Samantha and our 3 children

Mary Margaret Ara, MD

Principal Investigator

Specialty: Family Medicine
Medical Education: The University of Texas at Austin; The University of Texas Medical School at Houston (McGovern School of Medicine)
Residency: Christus Spohn Family Medicine Residency Program Corpus Christi

Practicing Since: 2011
Certification/publications: Board Certified by American Board of Family Medicine

Provider Background: Dr. Ara is a native of South Texas. She has worked for more than a decade in the Corpus Christi area, providing inpatient and outpatient care to a diverse population of patients. She has been involved with residency education and has served on numerous hospital committees and boards during her time in Corpus. Dr. Ara is passionate about preventative measures and counseling her patients on ways they can help prevent disease progression and how to identify early signs of medical comorbidities. Dr. Ara joins Pinnacle with a desire to work to identify potential treatments for metabolic syndrome associated liver disease and improve quality of life for her patients.

Hobbies: When not at the office, Dr. Ara loves to spend time with her husband Reagan and their three children. They enjoy rooting on their Texas Longhorns! And as a child of ranchers, she enjoys being outdoors, working cattle and riding horses.

Nirupama Esther Jerome,

Principal Investigator
Austin, TX

Education: Doctor of Nursing Practice, Purdue university, West Lafayette, Indiana

Background: From her hometown in India, Esther is multi-lingual to include: english, telugu and tamil. She comes from a previous background in internal medicine, hospitalist, orthopedic surgery, cardiology, and cardio thoracic surgery.


  • Certificate in post-graduate cardiothoracic nursing and operation theatre technique and management
  • Member of American Association of Nurse Practitioners, American Nurses Association, The Association of Clinical Research Professionals, Austin Advanced Practice Nurses, and Texas DNP

Provider Quote: To provide patient-centered care with excellence so patients are empowered and motivated to achieve their health care goals.

Lauren Jones, MPAS, PA-C

San Antonio, TX

Education: Bachelor of Science in Human Biology at The University of Texas at Austin
Master of Physician Assistant Studies at The University of Texas Medical Branch at Galveston
Background: Raised in Houston, Texas, Lauren brings outstanding skills and knowledge in clinical research to Pinnacle. Lauren is NCCPA certified and has been working in clinical research since 2015.
Provider Quote: I strive to provide quality medical care that instills positive mindsets, lifestyles, and health in patients.

Shalene Thomas, MPAS, PA-C

San Antonio, TX

Education: BS Biology at the University of Texas Health at San Antonio
MPAS at the University of Texas Health at San Antonio.
Background: Calling San Antonio her hometown, Shalene comes from a previous background in internal medicine and family practice. Shalene is NCCPA certified, a member of Bexar County Physician Assistant Society, and a bilingual Spanish speaker.
Provider Quote: I am passionate about providing quality and compassionate care, research, and patient education.

Ana Diaz, MPAS, PA-C

San Antonio, TX

Education: BBA Finance at the University of Texas at San Antonio.
MPAS at the University of Texas Health San Antonio

Background: Ana comes from a family medicine and research background. She has previously worked for the Alliance for Health Policy in Washington, DC, South Texas Veterans Health Care System, and UT Health San Antonio Community Pediatrics. She is NCCPA certified and a bilingual spanish speaker.

Provider Quote: Striving to empower patients to live a healthier life and acquire knowledge to better manage their health conditions.

Travis Kenney, FNP-C

Austin, TX

Education: Texas Woman’s University, Dallas, Texas

Background: From the hometown of Arlington, Texas, Travis previously worked as an ED RN and as a NP in outpatient neurology.

Provider Quote: To educate patients and to help patients achieve their health goals.

Graciela Marje,

Edinburg, TX

Education:  Bachelor’s in Science of Nursing from Chamberlain University

Master’s in Science in Nursing from Chamberlain College of Nursing

Provider Quote: I strive to educate and motivate patients on disease prevention and healthy lifestyles.

Background: Born and raised in the Rio Grande Valley, Texas. Gracie joins Pinnacle with 25 years of medical experience as a Registered Nurse with 17 years as a previous American Board Certified Gastroenterology Registered Nurse. She is an AANP Certified Family Nurse Practitioner. She has been serving the Rio Grande community with experience in Endoscopy and Family Medicine and is bilingual in Spanish. Gracie joined the research field in 2021 as a Sub-Investigator with South Texas Research Institute and is excited to continue and join the new venture with Pinnacle.
Petra Makia Nfonoyim, ACNP-BC, CRA

Petra Makia-Nfonoyim,

South San Antonio, TX

Education:  Bachelor of Science in Nursing from Langston University
Master’s of Science in Nursing from The University of Texas at El Paso.

Background: Petra is a skilled Clinical Research Associate and Acute Care Nurse Practitioner with over 11 years of experience in healthcare, providing clinical management, nursing care, and operations support in a variety of medical therapeutic areas. Petra joins Pinnacle with extensive expertise in supporting all aspects of investigation and research. She is excited to build valuable relationships with the San Antonio community.

Provider Quote: It gives me great joy and satisfaction when I make the health of my patients their wealth by improving their therapeutic outcomes through my guidance from evidence-based practice in research.