NPI | 1457765620 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0006228) |
Additional Taxonomies | 133V00000X Dietitian, Registered |
363A00000X Physician Assistant | |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2014-06-16 |
Last Update Date | 2023-04-20 |