NPI | 1285100479 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005596) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2025-0069) |
Enumeration Date | 2018-10-16 |
Last Update Date | 2025-07-29 |