| NPI | 1104096569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 2764) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0002764) |
| Enumeration Date | 2008-03-01 |
| Last Update Date | 2020-07-24 |