| NPI | 1306336862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: SC 5374) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA11993) |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2025-02-01 |