NPI | 1568465722 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA04282) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04282) |
Enumeration Date | 2005-05-23 |
Last Update Date | 2024-02-16 |