| NPI | 1023079191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CO 1174) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 0001174) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2023-10-12 |