NPI | 1659476398 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2021-0130) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 988) |
363A00000X Physician Assistant (Licence: CO PA.005343) | |
Enumeration Date | 2006-09-14 |
Last Update Date | 2024-11-08 |