| NPI | 1962450858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA04714) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX PA04714) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2025-01-24 |