NPI | 1134372261 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9104739) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA06250) |
Enumeration Date | 2008-11-03 |
Last Update Date | 2014-03-10 |