NPI | 1528574761 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12960) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021593-1) |
363A00000X Physician Assistant | |
Enumeration Date | 2017-12-26 |
Last Update Date | 2023-09-18 |