| NPI | 1821271685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA19346) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA03551) |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2021-06-16 |