NPI | 1154668440 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 2221) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA19136) |
Enumeration Date | 2013-01-07 |
Last Update Date | 2025-06-03 |