NPI | 1689986168 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA52293) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: TX PA 06619) |
Enumeration Date | 2010-07-13 |
Last Update Date | 2023-08-30 |