NPI | 1063937449 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 10444481-1206) |
Enumeration Date | 2017-08-07 |
Last Update Date | 2018-03-17 |