| NPI | 1720480049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59305) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA09166) |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2022-11-18 |