NPI | 1174916449 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006220) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA60539314) |
Enumeration Date | 2015-03-11 |
Last Update Date | 2022-10-17 |