NPI | 1043252968 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0002770) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN PA0000001278) |
Enumeration Date | 2006-06-12 |
Last Update Date | 2024-04-25 |