NPI | 1346759461 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0005147) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005147) |
Enumeration Date | 2017-09-20 |
Last Update Date | 2019-08-16 |