| NPI | 1356381263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA04746) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA19125) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2021-08-26 |