NPI | 1275790107 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05766) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 1077371) |
363AS0400X Physician Assistant, Surgical (Licence: TX PA05766) | |
Enumeration Date | 2008-05-19 |
Last Update Date | 2013-08-28 |