| NPI | 1740313584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA22270) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04075) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2019-08-29 |