| NPI | 1063752145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 63407) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX P08222) |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2024-02-07 |