NPI | 1497940316 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA08693) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085002695) |
Enumeration Date | 2007-09-13 |
Last Update Date | 2016-08-15 |