| NPI | 1730602376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18331) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA PA57700) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2024-11-15 |