NPI | 1184009920 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0004384) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0004384) |
Enumeration Date | 2015-07-22 |
Last Update Date | 2024-05-06 |