NPI | 1114206893 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0003234) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA-3234) |
Enumeration Date | 2011-08-11 |
Last Update Date | 2018-10-23 |