NPI | 1487076089 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004434) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017313) |
Enumeration Date | 2014-01-16 |
Last Update Date | 2023-10-16 |