| NPI | 1770177594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA14349) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-02-23 |
| Last Update Date | 2022-09-21 |