| NPI | 1922874981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: UT 13487669-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-11-30 |
| Last Update Date | 2025-02-19 |