NPI | 1972176832 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA C09071) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA14774) |
363A00000X Physician Assistant (Licence: VA 0110-008764) | |
207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX PA14774) | |
363A00000X Physician Assistant | |
Enumeration Date | 2021-07-20 |
Last Update Date | 2023-09-19 |