NPI | 1417566837 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2335) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0009098) |
Enumeration Date | 2020-07-31 |
Last Update Date | 2025-06-24 |