NPI | 1376092841 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10815) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2016-09-26 |
Last Update Date | 2021-08-18 |