NPI | 1699158477 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 004298) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-01897) |
363AS0400X Physician Assistant, Surgical | |
Enumeration Date | 2015-06-30 |
Last Update Date | 2019-07-24 |