NPI | 1952414872 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0003975) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 3975) |
363AM0700X Physician Assistant, Medical (Licence: AZ 3477) | |
Enumeration Date | 2006-08-16 |
Last Update Date | 2019-08-16 |