| NPI | 1629695044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13746) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 58184) |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2021-03-02 |