| NPI | 1003058819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA06188) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA06188) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX PA06188) | |
| Enumeration Date | 2009-03-26 |
| Last Update Date | 2013-03-08 |