| NPI | 1558561175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 22709) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04470) |
| Enumeration Date | 2007-07-22 |
| Last Update Date | 2012-11-13 |