NPI | 1578013314 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10835) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2016-10-05 |
Last Update Date | 2021-12-07 |