| NPI | 1598300618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14864) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 208G00000X) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2019-11-13 |
| Last Update Date | 2023-01-11 |