NPI | 1518319094 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA0005582) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: CO 5582) | |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2016-07-07 |
Last Update Date | 2021-04-13 |