NPI | 1114492964 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005592) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2018-10-09 |
Last Update Date | 2021-12-20 |