| NPI | 1336493709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 5680506-1206) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: UT 5680506-1206) |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2024-06-20 |