| NPI | 1386255446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 13007674-1206) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95160449) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2022-10-11 |