NPI | 1467246868 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18982) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA18982) |
Enumeration Date | 2025-04-09 |
Last Update Date | 2025-04-15 |