| NPI | 1083272025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA0007362) |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2025-01-29 |