| NPI | 1770596272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA02537) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO PA0004999) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX PA02537) | |
| 363AS0400X Physician Assistant, Surgical (Licence: CO PA0004999) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2022-07-21 |