NPI | 1477215952 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA15076) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-10-12 |
Last Update Date | 2022-02-04 |