NPI | 1194107250 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13813) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2015-06-25 |
Last Update Date | 2024-07-27 |