NPI | 1154520351 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA03100) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX PA03100) |
Enumeration Date | 2007-07-17 |
Last Update Date | 2021-04-13 |