NPI | 1235811654 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0008155) |
Additional Taxonomies | 363A00000X Physician Assistant |
363AM0700X Physician Assistant, Medical | |
363AS0400X Physician Assistant, Surgical (Licence: CO PA.0008155) | |
363AS0400X Physician Assistant, Surgical | |
Enumeration Date | 2023-08-04 |
Last Update Date | 2024-07-09 |