| NPI | 1063559607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA07007) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL 9103920) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2012-08-06 |