| NPI | 1083940712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07046) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CA PA20638) |
| Enumeration Date | 2009-10-30 |
| Last Update Date | 2017-04-05 |