NPI | 1508911314 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114320) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA02114) |
Enumeration Date | 2007-01-24 |
Last Update Date | 2021-06-04 |