| NPI | 1376883884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 8042) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA08315) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2013-02-20 |
| Last Update Date | 2020-05-19 |