| NPI | 1154762359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 55805) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA08534) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2022-03-01 |