NPI | 1699172734 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA09467) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX PA09467) |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2014-12-03 |
Last Update Date | 2021-12-17 |