NPI | 1548838683 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14762) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-06-15 |
Last Update Date | 2021-12-01 |