| NPI | 1295262087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA 10825) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA10825) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2022-01-04 |