| NPI | 1063645554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 264696-1206) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: UT APPLIED) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2016-04-29 |