| NPI | 1174833008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05712) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA19352) |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2013-09-06 |