| NPI | 1164615548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CO 2463) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2463) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2008-08-14 |