NPI | 1609281864 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0005355) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C05425) |
Enumeration Date | 2014-06-26 |
Last Update Date | 2019-07-30 |