NPI | 1225635311 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14003) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX 714785) |
Enumeration Date | 2020-10-02 |
Last Update Date | 2025-09-02 |