| NPI | 1154688620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0003878) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA 0003878) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2021-01-06 |