NPI | 1164931275 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1618) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005146) |
Enumeration Date | 2017-09-21 |
Last Update Date | 2021-01-15 |