| NPI | 1073591491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA 15786) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX TX PA 03352) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2010-12-20 |