NPI | 1447640057 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA09938) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA09938) |
363A00000X Physician Assistant (Licence: NJ 25MP00359600) | |
Enumeration Date | 2015-02-03 |
Last Update Date | 2022-05-06 |