NPI | 1538423850 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA 09188) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 2150) |
Enumeration Date | 2012-07-02 |
Last Update Date | 2017-01-09 |