NPI | 1497305908 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0007298) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.007275) |
Enumeration Date | 2019-09-17 |
Last Update Date | 2022-12-12 |