| NPI | 1285871053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT034925) |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX SA00606) | |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2020-10-13 |