| NPI | 1013455880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX 14460) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| 363A00000X Physician Assistant (Licence: CA PA57261) | |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2022-08-09 |