NPI | 1528503117 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA11074) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2017-01-05 |
Last Update Date | 2023-10-01 |