NPI | 1174945166 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA10587) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-04692) |
Enumeration Date | 2014-01-10 |
Last Update Date | 2016-12-01 |