| NPI | 1609458207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA14998) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: TX PA14998) | |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2024-08-29 |