NPI | 1376046086 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11912) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2018-03-09 |
Last Update Date | 2022-09-02 |