NPI | 1174899330 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07755) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54916) |
Enumeration Date | 2012-03-31 |
Last Update Date | 2023-04-19 |