NPI | 1609648708 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0008174) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0008174) |
Enumeration Date | 2023-10-23 |
Last Update Date | 2023-12-06 |