NPI | 1124720107 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17997) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AR PA-1169) |
Enumeration Date | 2023-03-21 |
Last Update Date | 2024-06-27 |