| NPI | 1053678854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0001278) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 1278) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2023-10-03 |