| NPI | 1942733514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA58663) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA11106) |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2020-12-03 |