NPI | 1154693729 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 32466) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0009103) |
363A00000X Physician Assistant (Licence: NV PA1326) | |
Enumeration Date | 2012-01-30 |
Last Update Date | 2025-03-15 |