NPI | 1558896225 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13251) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54892) |
Enumeration Date | 2017-05-01 |
Last Update Date | 2021-12-17 |