NPI | 1437800182 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA18116) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA18116) |
Enumeration Date | 2022-01-14 |
Last Update Date | 2024-09-26 |