NPI | 1013033760 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA02916) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA02916) |
Enumeration Date | 2007-03-22 |
Last Update Date | 2013-07-08 |