NPI | 1689191132 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11475) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3999) |
Enumeration Date | 2017-08-25 |
Last Update Date | 2022-09-28 |