| NPI | 1669893848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA08831) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057536) |
| Enumeration Date | 2013-12-14 |
| Last Update Date | 2022-03-04 |