NPI | 1962037556 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007395) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9956) |
363A00000X Physician Assistant (Licence: CO PA.0006061) | |
Enumeration Date | 2020-03-04 |
Last Update Date | 2021-03-23 |