NPI | 1114396777 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009208) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA09983) |
Enumeration Date | 2015-09-24 |
Last Update Date | 2023-05-19 |