NPI | 1619591070 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CO PA.0006659) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-06-02 |
Last Update Date | 2024-07-16 |