| NPI | 1740935543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17018) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL PA9115578) |
| Enumeration Date | 2022-02-21 |
| Last Update Date | 2023-12-06 |