| NPI | 1194391615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery (Licence: TX PA14635) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA14635) |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2023-04-14 |