NPI | 1518674316 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17835) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2024022554) |
Enumeration Date | 2022-11-01 |
Last Update Date | 2025-08-27 |