| NPI | 1013117506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA0003683) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX PA03761) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2015-08-28 |