NPI | 1477228369 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14639) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2021-08-12 |
Last Update Date | 2021-12-30 |