NPI | 1124615356 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006507) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006507) |
Enumeration Date | 2020-12-22 |
Last Update Date | 2023-06-09 |