| NPI | 1225753056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA16130) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA16130) |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2024-03-12 |