| NPI | 1861689200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA14826) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA17711) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2021-10-04 |