NPI | 1962770917 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA08484) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006203) |
Enumeration Date | 2011-12-06 |
Last Update Date | 2022-03-09 |