| NPI | 1073515169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA04399) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AL PA-658) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2021-12-08 |