NPI | 1417442591 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA12134) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA12134) |
Enumeration Date | 2018-06-29 |
Last Update Date | 2024-09-10 |