| NPI | 1780786640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: TX PA 03597) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2021-01-22 |