NPI | 1275231441 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.8667) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MT MED-PAC-LIC-117488) |
Enumeration Date | 2023-02-17 |
Last Update Date | 2025-03-26 |