| NPI | 1851933501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: UT 11477475-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 11477475-1206) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2021-11-02 |