NPI | 1528619640 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15800) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA061051) |
Enumeration Date | 2019-09-20 |
Last Update Date | 2022-10-04 |