| NPI | 1710006317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA04307) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA17343) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2007-07-08 |