| NPI | 1124856547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA19422) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD C0009602) |
| 363A00000X Physician Assistant (Licence: MD C0009602) | |
| 363A00000X Physician Assistant (Licence: TX PA19422) | |
| Enumeration Date | 2024-07-25 |
| Last Update Date | 2025-09-18 |