NPI | 1225657927 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 7088) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 7838) |
363A00000X Physician Assistant (Licence: CO 7088) | |
Enumeration Date | 2020-04-13 |
Last Update Date | 2024-10-08 |