NPI | 1275966376 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005794) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004317) |
363A00000X Physician Assistant (Licence: DC PA031197) | |
Enumeration Date | 2013-08-13 |
Last Update Date | 2023-01-28 |