| NPI | 1073853446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0004397) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA055860) |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA0004397) | |
| Enumeration Date | 2013-02-22 |
| Last Update Date | 2018-10-22 |