| NPI | 1417591108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA18675) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 3098) |
| 363AS0400X Physician Assistant, Surgical (Licence: TX 18675) | |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2025-07-29 |