| NPI | 1114278025 |
|---|---|
| Former Name | DIANNA LYNN TRUJILLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0004565) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-03820) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2016-03-24 |