NPI | 1467888636 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: UT 8797960-1206) |
Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: UT 8797960-1206) |
Enumeration Date | 2013-09-19 |
Last Update Date | 2024-07-02 |