| NPI | 1003406406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0006699) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO T-PA.0000008) |
| 363A00000X Physician Assistant (Licence: CO PA.0006699) | |
| Enumeration Date | 2021-01-20 |
| Last Update Date | 2021-07-15 |