NPI | 1467884999 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60430529) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA0003761) |
Enumeration Date | 2013-08-07 |
Last Update Date | 2021-01-07 |