| NPI | 1528602778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA16282) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110007880) |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2023-04-19 |