NPI | 1902896855 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA12104) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: LA A10195) |
Enumeration Date | 2005-10-24 |
Last Update Date | 2020-01-23 |