NPI | 1538449152 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0003155) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0003155) |
363A00000X Physician Assistant (Licence: NM PA2013-0090) | |
363A00000X Physician Assistant | |
Enumeration Date | 2011-08-26 |
Last Update Date | 2024-07-10 |