NPI | 1811285307 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0003915) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21630) |
363A00000X Physician Assistant (Licence: CO PA0003915) | |
Enumeration Date | 2011-07-18 |
Last Update Date | 2020-03-05 |