NPI | 1407328578 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9119277) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12717) |
Enumeration Date | 2018-12-29 |
Last Update Date | 2024-10-18 |