| NPI | 1316130438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA11428) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA 19265) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2018-04-11 |