| NPI | 1417519471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA15740) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA56881) |
| Enumeration Date | 2019-06-30 |
| Last Update Date | 2022-08-05 |