NPI | 1124456512 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08964) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2013-10-22 |
Last Update Date | 2021-01-26 |