NPI | 1790332666 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0008470) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA15116) |
Enumeration Date | 2019-08-24 |
Last Update Date | 2024-07-30 |