NPI | 1538723408 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12755) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-04-26 |
Last Update Date | 2019-05-15 |