| NPI | 1528451812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: TX PA09643) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA54434) |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2018-04-18 |