NPI | 1386305969 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15909) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2022-01-05 |
Last Update Date | 2023-08-01 |