| NPI | 1598164766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA51753) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA15098) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2022-03-01 |