| NPI | 1740685007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10246) |
| 363A00000X Physician Assistant (Licence: AZ 5776) | |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2021-12-08 |