NPI | 1093306045 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14838) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062033) |
Enumeration Date | 2021-02-02 |
Last Update Date | 2024-08-22 |