NPI | 1871191833 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006489) |
Enumeration Date | 2020-10-13 |
Last Update Date | 2024-10-22 |