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 |