| NPI | 1891726667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA05381) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 0010-00135) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2022-01-04 |