NPI | 1427080399 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA03391) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: OK 2298) |
363AS0400X Physician Assistant Surgical (Licence: TX PA03391) | |
Enumeration Date | 2006-07-07 |
Last Update Date | 2024-01-23 |