| NPI | 1023447679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0003759) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-01650) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2021-03-29 |