| NPI | 1285989491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA15789) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 22577) |
| 363AS0400X Physician Assistant, Surgical (Licence: CA 22577) | |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2024-11-06 |