| NPI | 1780853341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA PA14602) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA PA14602) |
| 363A00000X Physician Assistant (Licence: TX PA05575) | |
| 363AM0700X Physician Assistant Medical (Licence: TX PA05575) | |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2019-10-25 |