NPI | 1487319364 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0008109) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0008182) |
363A00000X Physician Assistant (Licence: CO PA.0008109) | |
Enumeration Date | 2021-11-04 |
Last Update Date | 2024-02-13 |