NPI | 1356424782 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0001736) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-01458) |
363A00000X Physician Assistant (Licence: AK 917) | |
363A00000X Physician Assistant (Licence: WA PA60636968) | |
363A00000X Physician Assistant (Licence: CO 1736) | |
363AM0700X Physician Assistant, Medical (Licence: CO 1736) | |
Enumeration Date | 2006-10-21 |
Last Update Date | 2024-11-13 |