NPI | 1437460300 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA06750) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX Applicant) |
Enumeration Date | 2010-06-25 |
Last Update Date | 2011-10-24 |