| NPI | 1295247989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA11620) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX PA11620) |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2020-12-04 |