NPI | 1528490976 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0004218) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 2948) |
Enumeration Date | 2013-08-07 |
Last Update Date | 2015-08-04 |