NPI | 1124431184 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09112) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2014-06-07 |
Last Update Date | 2021-07-05 |