| NPI | 1134672108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61372) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX 653659) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2022-09-27 |