| NPI | 1730961517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA17530) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA17530) |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2025-11-25 |