NPI | 1790085553 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA07780) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C0004356) |
Enumeration Date | 2010-10-27 |
Last Update Date | 2024-04-24 |