NPI | 1003257742 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0003735) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO PA0003735) |
Enumeration Date | 2013-07-10 |
Last Update Date | 2018-05-11 |