NPI | 1609474469 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007926) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: PA MA061899) | |
Enumeration Date | 2020-10-14 |
Last Update Date | 2024-06-14 |