| NPI | 1306315502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61566) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12414) |
| Enumeration Date | 2018-11-16 |
| Last Update Date | 2022-12-02 |