| NPI | 1013361112 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA60463) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10411) | 
| 363A00000X Physician Assistant (Licence: NE 2234) | |
| Enumeration Date | 2016-04-15 | 
| Last Update Date | 2022-10-13 |