NPI | 1013402528 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005822) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4473) |
Enumeration Date | 2018-06-27 |
Last Update Date | 2019-08-26 |