| NPI | 1629031984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA19518) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04348) |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2014-07-16 |