| NPI | 1164082301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0006970) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 1163717) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2022-02-24 |