NPI | 1528681525 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15212) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9113158) |
Enumeration Date | 2020-05-26 |
Last Update Date | 2024-01-02 |