| NPI | 1851875215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA56044) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA12205) |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2022-03-22 |