NPI | 1285266270 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14590) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 2443) |
363A00000X Physician Assistant (Licence: IA 100037) | |
Enumeration Date | 2020-02-07 |
Last Update Date | 2021-08-25 |