NPI | 1366703118 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA07112) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: TX PA07112) |
363A00000X Physician Assistant (Licence: TX PA07112) | |
363AS0400X Physician Assistant, Surgical (Licence: TX PA07112) | |
207N00000X Dermatology (Licence: TX PA07112) | |
Enumeration Date | 2012-06-07 |
Last Update Date | 2025-08-29 |