NPI | 1518366863 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15724) |
Additional Taxonomies | 363AS0400X Physician Assistant Surgical |
Enumeration Date | 2014-08-21 |
Last Update Date | 2025-08-08 |