NPI | 1417597766 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18107) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C0007397) |
Enumeration Date | 2020-01-14 |
Last Update Date | 2024-07-30 |