NPI | 1427455435 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18732) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 13856) |
363AM0700X Physician Assistant, Medical (Licence: GA 7423) | |
Enumeration Date | 2014-11-20 |
Last Update Date | 2025-02-19 |