| NPI | 1972929008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: TX 769149) |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2024-10-11 |