NPI | 1114671708 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15908) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-02-11 |
Last Update Date | 2022-11-07 |