| NPI | 1114335114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0007376) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 007264) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2022-08-11 |