NPI | 1962069443 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12825) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA12825) |
Enumeration Date | 2019-05-21 |
Last Update Date | 2023-07-13 |