| NPI | 1558550806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA22881) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA05831) |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2016-06-20 |