NPI | 1871055319 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006934) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
363A00000X Physician Assistant (Licence: LA 1163545) | |
Enumeration Date | 2019-04-03 |
Last Update Date | 2022-02-16 |