| NPI | 1235674664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: TX PA15835) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: WA PA60720076) |
| Enumeration Date | 2016-12-20 |
| Last Update Date | 2022-05-31 |