| NPI | 1801539697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15405) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: TX PA15405) |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2026-01-14 |