| NPI | 1366084634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA15769) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 4529) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2022-06-09 |