| NPI | 1669769733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA07398) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: HI AMD-1438) |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2025-03-28 |