| NPI | 1912509910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX 14099) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 58692) |
| Enumeration Date | 2020-11-13 |
| Last Update Date | 2020-11-13 |