| NPI | 1740816982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 5458) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA13587) |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2023-10-02 |