| NPI | 1831475748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: UT 9316490-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2021-12-20 |