NPI | 1568816882 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2024-0024) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0004612) |
Enumeration Date | 2016-04-22 |
Last Update Date | 2024-07-22 |