NPI | 1124331707 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0003049) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 3049) |
Enumeration Date | 2010-07-23 |
Last Update Date | 2018-11-02 |