| NPI | 1134497282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 8483264-1206) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NM PA2011-0045) |
| Enumeration Date | 2011-12-05 |
| Last Update Date | 2022-07-21 |