| NPI | 1114585833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA13189) |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2023-11-01 |