NPI | 1770250680 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA18310) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: 1185916) |
Enumeration Date | 2021-08-27 |
Last Update Date | 2025-07-29 |