NPI | 1629493689 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005321) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005321) |
Enumeration Date | 2014-02-27 |
Last Update Date | 2023-03-17 |