NPI | 1790315737 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA14881) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
363A00000X Physician Assistant | |
Enumeration Date | 2020-01-17 |
Last Update Date | 2021-11-30 |