NPI | 1851867626 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MD CO7263) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD C07263) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-10-19 |
Last Update Date | 2023-06-22 |