NPI | 1407372410 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0005061) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005061) |
Enumeration Date | 2017-08-21 |
Last Update Date | 2020-11-09 |