NPI | 1134881360 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14971) |
Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: TX PA14971) |
Enumeration Date | 2021-10-05 |
Last Update Date | 2022-02-11 |