| NPI | 1124022934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA02498) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: TX PA02498) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2007-07-08 |