| NPI | 1639746431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15801) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 59592) |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2022-07-12 |