NPI | 1154337863 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA13080) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 4683) |
Enumeration Date | 2006-08-01 |
Last Update Date | 2024-03-01 |