NPI | 1295275857 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA11119) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2017-03-02 |
Last Update Date | 2024-04-26 |