| NPI | 1093072142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA22234) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA PA22234) |
| 363AM0700X Physician Assistant, Medical (Licence: TX pa07659) | |
| 363AS0400X Physician Assistant, Surgical (Licence: TX PA07659) | |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2014-09-16 |