| NPI | 1538977814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA18408) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA18408) |
| Enumeration Date | 2024-12-19 |
| Last Update Date | 2025-02-13 |