| NPI | 1154915031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 58825) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026306) |
| 363A00000X Physician Assistant (Licence: TX PA13824) | |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2021-04-05 |