| NPI | 1306212543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA12735) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2826) |
| 363A00000X Physician Assistant (Licence: MS PA00290) | |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2024-02-21 |