NPI | 1225611361 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0008686) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA15745) |
Enumeration Date | 2021-05-05 |
Last Update Date | 2024-09-13 |