NPI | 1336538776 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA0004903) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA057358) |
Enumeration Date | 2015-01-22 |
Last Update Date | 2024-01-04 |