| NPI | 1154904241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007484) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO PA.0007) |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2022-11-01 |