NPI | 1649875345 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA142244) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-12-01 |
Last Update Date | 2021-06-09 |