NPI | 1922653757 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CO PA.0007271) |
Additional Taxonomies | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: PA MA060843) |
Enumeration Date | 2019-08-08 |
Last Update Date | 2022-10-30 |