| NPI | 1164471736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0004057) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0004057) |
| 363A00000X Physician Assistant (Licence: MN 9264) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2018-10-16 |