NPI | 1558973909 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0007371) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA.61080748) |
Enumeration Date | 2020-08-18 |
Last Update Date | 2022-09-15 |