| NPI | 1811287824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08143) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA21555) |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2016-12-12 |