NPI | 1295187615 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 10076215) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2016-07-09 |
Last Update Date | 2023-01-17 |