| NPI | 1114031812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0001974) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 1974) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2022-10-21 |