NPI | 1851039713 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 13596306-1206) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: UT 13596306-1206) |
Enumeration Date | 2022-05-21 |
Last Update Date | 2024-03-04 |