NPI | 1639598204 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09118) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2014-04-10 |
Last Update Date | 2023-01-10 |