NPI | 1457870248 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16505) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00445300) |
Enumeration Date | 2017-09-13 |
Last Update Date | 2023-11-08 |