| NPI | 1003339649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11398) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX PA11398) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2022-07-21 |