NPI | 1760135842 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX 90418-283224121911) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
374U00000X Home Health Aide | |
Enumeration Date | 2022-01-30 |
Last Update Date | 2022-01-30 |