NPI | 1669598470 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 2734) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 2270) |
Enumeration Date | 2007-03-22 |
Last Update Date | 2009-03-11 |