NPI | 1063600526 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA05505) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA05505) |
363AM0700X Physician Assistant, Medical (Licence: TX PA05505) | |
Enumeration Date | 2007-10-10 |
Last Update Date | 2011-08-24 |