| NPI | 1255790366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA63277) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: TX PA10516) | |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2025-04-22 |