NPI | 1376215814 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA14975) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA14975) |
Enumeration Date | 2021-10-04 |
Last Update Date | 2025-06-12 |