NPI | 1295921716 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 1553) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 132595) |
363A00000X Physician Assistant (Licence: UT 14222468-1206) | |
363A00000X Physician Assistant (Licence: CO 1553) | |
Enumeration Date | 2007-09-18 |
Last Update Date | 2025-07-30 |