NPI | 1417047325 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA03509) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA03509) |
Enumeration Date | 2006-10-13 |
Last Update Date | 2025-06-30 |