NPI | 1407813447 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0000578) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0000578) |
Enumeration Date | 2006-04-26 |
Last Update Date | 2025-01-03 |