| NPI | 1316326465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA12055) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2025-03-24 |