| NPI | 1346421666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05189) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: TX PA05189) |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2011-05-10 |