| NPI | 1548631641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10065) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX 594227) |
| 363AS0400X Physician Assistant, Surgical (Licence: TX PA10065) | |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2023-05-15 |