NPI | 1578839593 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07761) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2012-03-23 |
Last Update Date | 2023-03-07 |