| NPI | 1700070992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA05223) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA 3762) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2021-04-13 |