NPI | 1194293738 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007138) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA6681) |
Enumeration Date | 2018-11-12 |
Last Update Date | 2022-03-16 |