NPI | 1265740401 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX PA03566) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA03566) |
Enumeration Date | 2010-09-22 |
Last Update Date | 2024-04-26 |