NPI | 1558610691 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08039) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015648) |
Enumeration Date | 2012-09-05 |
Last Update Date | 2018-04-04 |