NPI | 1811179773 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0002480) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA-2480) |
Enumeration Date | 2007-12-03 |
Last Update Date | 2018-10-22 |