NPI | 1235107533 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0008418) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA940) |
Enumeration Date | 2006-03-10 |
Last Update Date | 2024-05-08 |