| NPI | 1912568684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17957) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA58090) |
| 363AS0400X Physician Assistant, Surgical (Licence: CA PA58090) | |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2024-05-11 |