| NPI | 1568931574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA57911) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12379) |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2020-12-14 |