NPI | 1164884441 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 12510770-1206) |
Additional Taxonomies | 363A00000X Physician Assistant |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-03-24 |
Last Update Date | 2022-02-04 |