NPI | 1891404232 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007617) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9116592) |
207P00000X Emergency Medicine (Licence: FL PA9116592) | |
363A00000X Physician Assistant (Licence: NY 031818-01) | |
Enumeration Date | 2022-11-15 |
Last Update Date | 2024-08-15 |