NPI | 1972272789 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA16821) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA16821) |
363AS0400X Physician Assistant, Surgical (Licence: TX PA16821) | |
Enumeration Date | 2021-09-07 |
Last Update Date | 2025-07-15 |