NPI | 1629095559 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12152) |
Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: DE C5-0000337) |
363A00000X Physician Assistant (Licence: PA MA052372) | |
Enumeration Date | 2006-07-16 |
Last Update Date | 2022-07-19 |