NPI | 1336512771 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12860) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057963) |
Enumeration Date | 2015-11-06 |
Last Update Date | 2021-10-18 |