NPI | 1013283621 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA0003385) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055409) |
Enumeration Date | 2012-03-28 |
Last Update Date | 2024-07-22 |