NPI | 1801239793 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08241) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2014001343) |
Enumeration Date | 2013-04-10 |
Last Update Date | 2022-07-21 |