| NPI | 1578734455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05599) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA20589) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2022-01-03 |