| NPI | 1053928382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX pa13921) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA13921) |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2024-01-24 |