| NPI | 1144502519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004749) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03100) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2016-08-18 |