NPI | 1003422502 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15579) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-09-20 |
Last Update Date | 2022-07-07 |