| NPI | 1033455530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX SA00649) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX SA00649) |
| Enumeration Date | 2013-01-02 |
| Last Update Date | 2023-05-02 |