NPI | 1528461829 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09554) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0005399) |
Enumeration Date | 2014-09-30 |
Last Update Date | 2021-05-28 |