NPI | 1871086637 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11772) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 2906) |
Enumeration Date | 2018-06-07 |
Last Update Date | 2025-09-18 |