NPI | 1740807189 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006324) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0006324) |
Enumeration Date | 2020-07-01 |
Last Update Date | 2024-01-17 |