NPI | 1124445051 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0003897) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0003897) |
Enumeration Date | 2014-03-28 |
Last Update Date | 2024-09-05 |