NPI | 1679018063 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006598) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: WA PA60701719) |
Enumeration Date | 2016-12-21 |
Last Update Date | 2021-10-28 |