| NPI | 1760122907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15330) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TX PA15330) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2022-05-05 |