| NPI | 1982182929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA12135) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12135) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2022-07-28 |