NPI | 1417440652 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.005388) |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CO PA.0005388) |
Enumeration Date | 2018-06-12 |
Last Update Date | 2021-11-10 |