NPI | 1407038631 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004391) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1349) |
Enumeration Date | 2007-11-29 |
Last Update Date | 2016-11-30 |