| NPI | 1497239719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14742) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA55994) |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2021-08-10 |