| NPI | 1518691344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11546) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 11546) |
| 363A00000X Physician Assistant (Licence: TX PA15937) | |
| Enumeration Date | 2022-07-16 |
| Last Update Date | 2023-10-11 |