NPI | 1336631498 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006576) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA031598) |
Enumeration Date | 2018-06-05 |
Last Update Date | 2022-09-01 |