| NPI | 1043512858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA09978) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 014197) |
| Enumeration Date | 2010-11-30 |
| Last Update Date | 2016-08-30 |