| NPI | 1023533759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005094) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 0005094) |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2020-09-25 |