NPI | 1821723891 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX 1325-P.A.) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 1325-P.A.) |
Enumeration Date | 2022-07-22 |
Last Update Date | 2023-04-25 |