NPI | 1508126913 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0004360) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2012-05-18 |
Last Update Date | 2021-02-11 |