| NPI | 1073672614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0002289) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2289) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2018-10-22 |