NPI | 1215502398 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17130) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-05-21 |
Last Update Date | 2024-01-10 |