| NPI | 1104628015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA19265) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX 799456) |
| Enumeration Date | 2025-03-24 |
| Last Update Date | 2025-08-15 |