| NPI | 1558896225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13251) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54892) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2021-12-17 |