NPI | 1770912313 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11896) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA11896) |
363AM0700X Physician Assistant, Medical (Licence: FL PA9107501) | |
363AS0400X Physician Assistant, Surgical (Licence: FL PA9107501) | |
Enumeration Date | 2013-11-04 |
Last Update Date | 2024-07-02 |