| NPI | 1528503117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA11074) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2023-10-01 |