NPI | 1942810965 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006312) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0006312) |
363AM0700X Physician Assistant, Medical (Licence: CO PA.0006312) | |
Enumeration Date | 2020-08-04 |
Last Update Date | 2020-08-04 |