| NPI | 1669889879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA09951) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 3199) |
| 363AS0400X Physician Assistant, Surgical (Licence: CT 3199) | |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA09951) | |
| Enumeration Date | 2014-07-20 |
| Last Update Date | 2023-04-10 |