NPI | 1073148946 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13568) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-03-11 |
Last Update Date | 2022-07-25 |