| NPI | 1508438094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16905) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026968) |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 026968) | |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2024-04-22 |