NPI | 1245583400 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0003354) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 3354) |
Enumeration Date | 2012-10-24 |
Last Update Date | 2018-10-16 |