NPI | 1609277342 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005268) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05196) |
363AM0700X Physician Assistant, Medical (Licence: NC 0010-05196) | |
Enumeration Date | 2014-09-12 |
Last Update Date | 2024-07-25 |