NPI | 1215562517 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0008937) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 322254) |
Enumeration Date | 2020-03-06 |
Last Update Date | 2025-06-09 |