NPI | 1518418599 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005369) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058496) |
Enumeration Date | 2016-10-14 |
Last Update Date | 2022-12-06 |