| NPI | 1912515545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15604) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 58745) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2023-03-17 |