NPI | 1265829451 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0006962) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05480) |
Enumeration Date | 2015-04-25 |
Last Update Date | 2023-05-30 |