NPI | 1568614279 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0003269) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 012868) |
Enumeration Date | 2008-10-14 |
Last Update Date | 2018-03-17 |