NPI | 1801454996 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA100369) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 5860) |
363A00000X Physician Assistant (Licence: CO PA.0005860) | |
Enumeration Date | 2019-06-03 |
Last Update Date | 2025-05-30 |