NPI | 1720108830 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0002374) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0002374) |
Enumeration Date | 2007-03-30 |
Last Update Date | 2025-08-20 |