NPI | 1043095706 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17068) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX PA17068) |
Enumeration Date | 2023-08-30 |
Last Update Date | 2023-08-30 |