NPI | 1356817423 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 11448584-1206) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-10-16 |
Last Update Date | 2021-09-20 |