NPI | 1275904211 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16267) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: TN 2861) | |
363AS0400X Physician Assistant Surgical (Licence: TN 2861) | |
Enumeration Date | 2015-10-16 |
Last Update Date | 2023-01-03 |