| NPI | 1831261031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: TX PA05092) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA05092) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2016-03-14 |