NPI | 1548301179 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA16250) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9116609) |
363AM0700X Physician Assistant, Medical (Licence: CO 847) | |
Enumeration Date | 2007-02-08 |
Last Update Date | 2022-11-22 |