| NPI | 1700535853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16962) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 60911) |
| Enumeration Date | 2022-03-23 |
| Last Update Date | 2023-11-21 |