| NPI | 1104013929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0002469) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2469) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2018-10-22 |