NPI | 1831406883 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C06453) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2158) |
363A00000X Physician Assistant (Licence: TX PA07073) | |
Enumeration Date | 2010-09-10 |
Last Update Date | 2019-06-24 |