NPI | 1194392506 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18026) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC Pending) |
Enumeration Date | 2021-06-06 |
Last Update Date | 2024-08-09 |