NPI | 1972913242 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0003866) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 8875493-1206) |
Enumeration Date | 2014-05-07 |
Last Update Date | 2021-05-13 |