NPI | 1124750310 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16683) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-06-27 |
Last Update Date | 2023-04-04 |