| NPI | 1184766354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO 4523) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA-18696) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2024-12-02 |