NPI | 1669825782 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13990) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2585) |
Enumeration Date | 2016-07-14 |
Last Update Date | 2021-01-29 |