NPI | 1750050225 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18040) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0006953) |
Enumeration Date | 2021-09-08 |
Last Update Date | 2024-09-24 |