NPI | 1750429155 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA04786) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 63230) |
363A00000X Physician Assistant (Licence: FL PA9114501) | |
Enumeration Date | 2007-02-01 |
Last Update Date | 2023-09-13 |