| NPI | 1386153641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11515) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: TX TEMPORARY) |
| Enumeration Date | 2017-09-29 |
| Last Update Date | 2018-03-17 |