NPI | 1508229600 |
---|---|
Former Name | SHELBY WINZENT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0004627) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2016-04-05 |
Last Update Date | 2021-11-04 |