NPI | 1740840651 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12894) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2019-06-13 |
Last Update Date | 2023-05-30 |