| NPI | 1942196654 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA19313) | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| Enumeration Date | 2025-06-17 | 
| Last Update Date | 2025-07-01 |