| NPI | 1912540006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA13077) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA13077) |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2022-10-29 |