NPI | 1922382662 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005611) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106098) |
363A00000X Physician Assistant (Licence: CA PA51294) | |
Enumeration Date | 2011-09-29 |
Last Update Date | 2019-09-27 |