| NPI | 1689902603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 10106906-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA20714) |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2024-06-25 |