NPI | 1720459043 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11500) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 6227) |
Enumeration Date | 2015-10-13 |
Last Update Date | 2022-12-16 |