| NPI | 1194372763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0005868) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO PA.0005868) |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005868) | |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2023-03-08 |