NPI | 1518503028 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14842) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 7675) |
Enumeration Date | 2019-11-19 |
Last Update Date | 2022-01-29 |