| NPI | 1881994036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA06830) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PATEMP) |
| 363AS0400X Physician Assistant, Surgical (Licence: TX PA06830) | |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2013-01-30 |