| NPI | 1932630688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA11178) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN 5965) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2024-08-06 |