NPI | 1740959881 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18498) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.007115) |
363AS0400X Physician Assistant, Surgical | |
Enumeration Date | 2021-09-11 |
Last Update Date | 2025-07-02 |