NPI | 1205590791 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 12533611-1206) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 8770) |
Enumeration Date | 2021-10-29 |
Last Update Date | 2024-12-11 |