| NPI | 1114046323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0002195) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2195) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2018-10-22 |