NPI | 1235600271 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12607) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2018-12-17 |
Last Update Date | 2022-05-05 |