NPI | 1811389356 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11791) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA11791) |
Enumeration Date | 2015-02-20 |
Last Update Date | 2025-01-23 |