NPI | 1851972210 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0006838) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0006838) |
Enumeration Date | 2021-04-17 |
Last Update Date | 2024-05-30 |