| NPI | 1427347178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA169660) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA06970) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2022-05-16 |