NPI | 1669769733 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA07398) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: HI AMD-1438) |
Enumeration Date | 2011-07-08 |
Last Update Date | 2025-03-28 |