NPI | 1871103531 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0006490) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: 1173623) |
Enumeration Date | 2020-08-06 |
Last Update Date | 2022-04-18 |