| NPI | 1033898044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007876) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9117110) |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2024-12-02 |