NPI | 1679098099 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005926) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2017-0056) |
Enumeration Date | 2017-08-07 |
Last Update Date | 2022-07-21 |