NPI | 1629841036 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17524) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2023-11-07 |
Last Update Date | 2024-02-06 |