| NPI | 1518936483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14148) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA13286) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2022-11-16 |