NPI | 1669794376 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006481) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110004555) |
Enumeration Date | 2010-02-22 |
Last Update Date | 2021-08-31 |