| NPI | 1649945122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15193) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NJ 25MP00637300) |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2022-04-14 |