| NPI | 1437868411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: UT 14230205-1206) |
| 363A00000X Physician Assistant (Licence: UT 14230205-1206) | |
| Enumeration Date | 2022-11-18 |
| Last Update Date | 2025-10-24 |