NPI | 1457521775 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115341) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA05581) |
363A00000X Physician Assistant | |
Enumeration Date | 2008-03-03 |
Last Update Date | 2022-01-28 |