| NPI | 1467601930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA19875) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA13007) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2019-11-13 |