| NPI | 1003579897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0007230) |
| Enumeration Date | 2021-10-19 |
| Last Update Date | 2022-05-10 |