NPI | 1609815828 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA04325) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA04325) |
363AS0400X Physician Assistant, Surgical (Licence: TX PA04325) | |
363AS0400X Physician Assistant, Surgical (Licence: MD PA58950) | |
Enumeration Date | 2006-06-05 |
Last Update Date | 2025-05-19 |