NPI | 1922435098 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA0005717) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003141) |
363A00000X Physician Assistant (Licence: PA MA056450) | |
363A00000X Physician Assistant (Licence: NY 016963) | |
Enumeration Date | 2013-10-03 |
Last Update Date | 2022-08-30 |