| NPI | 1205131356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA55297) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA07190) |
| Enumeration Date | 2011-01-21 |
| Last Update Date | 2018-08-20 |