| NPI | 1457924235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17916) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA61161) |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2024-06-20 |