NPI | 1578715637 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA06458) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA06458) |
363AS0400X Physician Assistant, Surgical (Licence: TX PA06458) | |
Enumeration Date | 2008-10-21 |
Last Update Date | 2022-01-27 |