| NPI | 1265255004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18560) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA65321) |
| Enumeration Date | 2024-10-31 |
| Last Update Date | 2024-12-11 |