NPI | 1003682659 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17797) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2023-11-27 |
Last Update Date | 2025-04-10 |