NPI | 1790302636 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13869) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 9813) |
Enumeration Date | 2020-06-26 |
Last Update Date | 2023-11-10 |