NPI | 1295386563 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0008461) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL 9112451) |
Enumeration Date | 2019-09-26 |
Last Update Date | 2025-04-03 |