| NPI | 1538710363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA15582) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 026309) |
| 363AM0700X Physician Assistant, Medical (Licence: OK 3092) | |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2023-02-04 |