| NPI | 1407155393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX 10-248) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT009639) |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX 10-248) | |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2023-04-11 |