NPI | 1063511798 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA00208) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX PA00208) |
Enumeration Date | 2006-09-21 |
Last Update Date | 2023-04-13 |