NPI | 1073869848 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA7443) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA19130) |
Enumeration Date | 2012-07-31 |
Last Update Date | 2025-06-23 |