| NPI | 1265157085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15137) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA15137) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA15137) | |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2024-03-13 |