| NPI | 1275904211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16267) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: TN 2861) | |
| 363AS0400X Physician Assistant, Surgical (Licence: TN 2861) | |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2023-01-03 |