NPI | 1366258451 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA19202) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA19202) |
Enumeration Date | 2024-12-04 |
Last Update Date | 2025-07-21 |