NPI | 1871082123 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-868) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX PA11380) |
Enumeration Date | 2018-05-02 |
Last Update Date | 2019-11-21 |