NPI | 1023735172 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16434) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2022-10-19 |
Last Update Date | 2023-03-24 |