| NPI | 1851647655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA22435) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA08290) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2019-03-22 |