| NPI | 1043721129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-1067) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: TX PA11698) |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2023-01-31 |