| NPI | 1174939094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 55406) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA09236) |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2018-09-12 |