| NPI | 1932599065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA10649) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 52104) |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2022-01-20 |