NPI | 1124644331 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18944) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-06-23 |
Last Update Date | 2025-04-25 |